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Serotonin Syndrome - A Focused Review
  • Nicolaj Mikkelsen,
  • Per Damkier,
  • Sidsel Arnspang Pedersen
Nicolaj Mikkelsen
Odense University Hospital

Corresponding Author:n.mikkelsen86@gmail.com

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Per Damkier
Odense University Hospital
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Sidsel Arnspang Pedersen
University of Southerne Denmark
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Abstract

Background: Serotonin syndrome is a potentially life-threatening syndrome with manifestations spanning from mild adverse effects to life-threatening toxicity. The syndrome is caused by overstimulation of serotonin receptors by serotonergic drugs. Since the use of serotonergic drugs is increasing, primarily due to the widespread use of selective serotonin reuptake inhibitors, cases of serotonin syndrome have likely seen a parallel increase. The true incidence of serotonin syndrome remains unknown due to its diffuse clinical presentation. Objectives: This review aims to provide a clinically focused overview of serotonin syndrome, covering its pathophysiology, epidemiology, clinical manifestations, diagnostic criteria, differential diagnosis, and treatment as well as classifying serotonergic drugs and their mechanism of action. The pharmacological context is emphasized, as it is crucial for detection and management of serotonin syndrome. Methods: Focused review based on a literature search using the PubMed database. Findings and conclusion: Serotonin syndrome can occur through therapeutic use or overdose of a single serotonergic drug, or as a drug interaction between two or more serotonergic drugs. Central clinical features consist of neuromuscular excitation, autonomic dysfunction and altered mental status, occurring in a patient undergoing new or altered serotonergic therapy. Early clinically recognition and treatment are crucial to prevent significant morbidity.
17 Mar 2023Submitted to Basic & Clinical Pharmacology & Toxicology
17 Mar 2023Review(s) Completed, Editorial Evaluation Pending
17 Mar 2023Submission Checks Completed
17 Mar 2023Assigned to Editor
21 Mar 2023Reviewer(s) Assigned
27 Apr 2023Editorial Decision: Revise Minor
08 May 20231st Revision Received
08 May 2023Submission Checks Completed
08 May 2023Assigned to Editor
08 May 2023Review(s) Completed, Editorial Evaluation Pending
10 May 2023Reviewer(s) Assigned
06 Jun 2023Editorial Decision: Accept